Harvard Health Letter

Bad backs: Are you happy with your treatment?

Harvard researchers develop a tool to improve decision-making.

Treatment for a herniated disc—the rupture of one of the cushions between the bones of your spine—can range from physical therapy to pain-relieving injections to surgery. But when you and your physician decide on a treatment plan, are you well informed about its possible effect on your quality of life down the road? "It's a big problem if patients don't know what the disease is and what their options are. Research shows that if we did a better job of informing and engaging patients, there would likely be fewer major surgeries," says Dr. Karen Sepucha, assistant professor of medicine at Harvard Medical School.

To combat the problem, Dr. Sepucha and her colleagues at Massachusetts General Hospital developed a survey, called a decision aid, to make sure people with back trouble understand all aspects of treatment. "We have multiple-choice knowledge questions to see if a patient understands the key information, and we ask a patient about goals and concerns to see if surgical or nonsurgical options may best meet their needs," says Dr. Sepucha. A doctor can then take the results and address any knowledge gaps.

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